Sugene Kim, MD

Cosmetic and Reconstructive Plastic Surgery

A Natural Approach, with a Personal Touch

920 Medical Plaza - Suite 300 | The Woodlands, TX 77380

Forehead Lift

A brow lift, or forehead lift, gently lifts the tissues of the forehead to restore a more youthful, refreshed look to the area above your eyes.  Conditions such as sagging brows, horizontal lines and furrows, and crow’s feet can be corrected or reduced through this surgery.  The brow lift is often performed in combination with eyelid surgery.

The Best Candidates for a Forehead Lift

The brow lift is commonly performed on patients around age 40-60, but the procedure may help anyone who has developed furrows or frown lines due to stress or muscle activity. Individuals with inherited conditions, such as a low, heavy brow or furrowed lines above the nose can achieve a more alert and refreshed look with this procedure.

How The Brow Lift Works

During a brow lift, the muscles and tissues that cause furrowing or drooping in the area are removed or sculpted to smooth the forehead, raise the eyebrows, and minimize frown lines.

Dr. Kim may use the conventional surgical method, in which the incision is hidden just behind the hairline; or she may use an endoscope, a viewing instrument that allows the procedure to be performed with minimal incisions.

Both the traditional and endoscopic technique provide smoother forehead skin and a more animated facial appearance.

Dr. Kim will help you decide which surgical approach will best achieve your cosmetic goals: the classic or open method, or the endoscopic forehead lift. During a consultation, she can explain why one of these techniques might be appropriate for you.

The traditional brow lift

Before the operation begins, your hair will be tied with rubber bands on either side of the incision line. Your head will not be shaved, but hair that is growing directly in front of the incision line may need to be trimmed.

For most patients, a coronal incision will be used. It follows a headphone-like pattern, starting at about ear level and running across the top of the forehead and down the other side of the head. The incision is usually made well behind the hairline so that the scar won’t be visible.

If your hairline is high or receding, the incision may be placed just at the hairline, to avoid adding even more height to the forehead. In patients who are bald or losing hair, a mid-scalp incision that follows the natural pattern of the skull bones is sometimes recommended. By wearing your hair down on your forehead, most such scars become relatively inconspicuous. Special planning is sometimes necessary for concealing the scar in male patients, whose hairstyles often don’t lend themselves as well to incision coverage.

If you are bald or have thinning hair, your surgeon may recommend a mid-scalp incision so the resulting scar follows the natural junction of two bones in your skull and is less conspicuous.

Working through the incision, the skin of the forehead is carefully lifted so that the underlying tissue can be removed and the muscles of the forehead can be altered or released. The eyebrows may also be elevated and excess skin at the incision point will be trimmed away to help create a smoother, more youthful appearance.

The incision is then closed with stitches or clips. Your face and hair will be washed to prevent irritation and the rubber bands will be removed from your hair. Although some plastic surgeons do not use any dressings, your doctor may choose to cover the incision with gauze padding and wrap the head in an elastic bandage.

The endoscopic brow lift

Typically, an endoscopic forehead lift requires the same preparation steps as the traditional procedure: the hair is tied back and trimmed behind the hairline where the incisions will be made.

However, rather than making one long coronal incision, your surgeon will make three, four or five short scalp incisions, each less than an inch in length. An endoscope, which is a pencil-like camera device connected to a television monitor, is inserted through one of the incisions, allowing the surgeon to have a clear view of the muscles and tissues beneath the skin. Using another instrument inserted through a different incision, the forehead skin is lifted and the muscles and underlying tissues are removed or altered to produce a smoother appearance. The eyebrows may also be lifted and secured into their higher position by sutures beneath the skin’s surface or by temporary fixation screws placed behind the hairline.

When the lift is complete, the scalp incisions will be closed with stitches or clips and the area will be washed. Gauze and an elastic bandage may also be used, depending on your surgeon’s preference.

Risks of Brow Lift Surgery

Complications are rare and usually minor when a forehead lift is performed by a qualified plastic surgeon. Yet, the possibility of complications must be considered.

Possible risks include the following:

  • The nerves that control eyebrow movement could be injured on one or both sides, causing inability to raise the eyebrows or wrinkle the forehead. Additional surgery would be required to correct this problem.
  • Formation of a broad scar or hair loss along scar edges: A scar revision surgery would be necessary to produce a thinner scar.
  • Temporary, or in some cases permanent loss of sensation along or just beyond the traditional brow lift incision line.
  • Infection and bleeding

The best way to reduce your risk of complications is to choose a qualified plastic surgeon and closely follow her instructions before and after your brow lift surgery.

Preparing For Your Surgery

Dr. Kim will give provide specific instructions to prepare for your brow lift, including guidelines on eating and drinking, smoking, and taking and avoiding certain vitamins and medications. Carefully following these instructions will help your surgery and your recovery proceed more smoothly.

If your hair is very short, you may wish to let it grow out before surgery, so that it’s long enough to hide the scars while they heal.

It is wise to arrange for someone to drive you home after your surgery, and to help you out for a day or two.

Anesthesia Used for The Procedure

Most forehead lifts are performed under local anesthesia, combined with a sedative to make you drowsy. You’ll be awake but relaxed, and although you may feel some tugging and mild discomfort, your forehead will be insensitive to pain. Some surgeons prefer to use general anesthesia, in which case you’ll sleep through the entire operation.

After Your Surgery

Recovery from traditional brow lift surgery may be quite different from that of endoscopic brow lift surgery.

Traditional brow lift patients may experience the following:

  • Numbness and temporary discomfort around the incision, which can be controlled with prescription medication.
  • Patients may be told to keep the head elevated for 2-3 days following surgery to keep the swelling down.
  • Swelling can also affect the cheeks and eyes, but should subside in a week or so.
  • Numbness on the top of your scalp may be replaced by itching. These sensations may take as long as six months to fully disappear.
  • Bandages will be removed a day or two after surgery and stitches or clips will be removed within two weeks.
  • Some of your hair around the incision may fall out and may temporarily be a bit thinner. Normal growth will usually resume within a few weeks or months. Permanent hair loss is rare.

Endoscopic forehead lift patients may experience the following:

  • Some numbness, incision discomfort and mild swelling.
  • Incision site pain is usually minimal, but can be controlled with medication, if necessary.
  • The stitches or staples used to close the incisions are usually removed within a week and the temporary fixation screws within two weeks.

Returning to Normal

Although you should be up and about in a day or two, plan on taking it easy for at least the first week after surgery. You should be able to shower and shampoo your hair within two days, or as soon as the bandage is removed.

Most patients are back to work or school in a week to 10 days. Endoscopic patients may feel ready to return even sooner. Vigorous physical activity should limited for several weeks, including jogging, bending, heavy housework, sex, or any activity that increases your blood pressure. Prolonged exposure to heat or sun should be limited for several months.

Most of the visible signs of surgery should fade completely within about three weeks. Minor swelling and bruising can be concealed with special camouflage makeup. You may feel a bit tired and let down at first, but your energy level will increase as you begin to look and feel better.

Your New Appearance

Most patients are pleased with the results of a forehead lift, no matter which surgical method was used. Often, patients don’t realize how much their sagging forehead contributed to the signs of aging until they see how much younger and more rested they appear after the lift.

To learn more about the brow lift, schedule a consultation with The Woodlands cosmetic surgeon, Dr. Kim, or call us at 281-363-4546